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创伤性蛛网膜下腔出血患者的长期认知功能障碍:患病率和危险因素。

Long-term cognitive dysfunction in patients with traumatic subarachnoid hemorrhage: prevalence and risk factors.

机构信息

Division of Neurosurgery, The Chinese University of Hong Kong, China.

出版信息

Acta Neurochir (Wien). 2012 Jan;154(1):105-11; discussion 111. doi: 10.1007/s00701-011-1198-8. Epub 2011 Oct 15.

Abstract

BACKGROUND

Cognition had recently been suggested as a supplement to traditional measures of neurological outcome. However, no data were available in the literature on long-term cognitive outcomes in patients with traumatic subarachnoid hemorrhage (tSAH).

OBJECTIVE

We explored the long-term cognitive profiles of patients with tSAH who had returned to the community, and the risk factors associated with this event.

METHODS

Patients with tSAH were contacted to obtain their consent to participate in the study of cognitive profiles and outcome. Forty-seven (42%) of 111 eligible patients completed all the assessments.

RESULTS

Time from ictus to assessment ranged from 3 to 5 years. No difference in patient characteristics was observed between those who participated and those who did not. In patients with tSAH who had returned to the community, domain deficits and cognitive impairment were correlated with the extended Glasgow outcome scale (GOS-E), and were predicted by age and Glasgow coma scale (GCS) on admission. The accuracies of classifications were 79% and 81%, respectively. The number of domain deficits was also correlated with GOS-E, and was predicted by age, GCS on admission, and the extent of tSAH, with a total R (2) value of 50%.

CONCLUSIONS

Long-term cognitive dysfunction is common after tSAH. In addition to GCS on admission and follow-up GOS-E, the extent of tSAH is an independent risk factor for the number of cognitive domain deficits that occur.

摘要

背景

认知功能最近被建议作为传统神经功能预后指标的补充。然而,在创伤性蛛网膜下腔出血(tSAH)患者的长期认知结局方面,文献中尚无相关数据。

目的

我们探讨了已返回社区的 tSAH 患者的长期认知特征,以及与该事件相关的风险因素。

方法

联系 tSAH 患者以获得其参与认知特征和结局研究的同意。在 111 名符合条件的患者中,有 47 名(42%)完成了所有评估。

结果

从发病到评估的时间范围为 3 至 5 年。参与和不参与的患者在患者特征方面没有差异。在已返回社区的 tSAH 患者中,领域缺陷和认知障碍与扩展格拉斯哥结局量表(GOS-E)相关,并由入院时的年龄和格拉斯哥昏迷量表(GCS)预测。分类的准确率分别为 79%和 81%。领域缺陷的数量也与 GOS-E 相关,并由年龄、入院时的 GCS 和 tSAH 的严重程度预测,总 R(2)值为 50%。

结论

tSAH 后长期认知功能障碍很常见。除了入院时的 GCS 和随访的 GOS-E 外,tSAH 的严重程度是发生认知领域缺陷数量的独立危险因素。

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